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Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

Although the debate about the interplay between quality management and organizational culture is long established, extant knowledge about their link is not consistent. This article attempts to fill such a gap by integrating current perspectives and insights through a literature review.

A domain-based literature review has been conducted, which followed the Scientific Procedures and Rationales for Systematic Literature Reviews. The knowledge core consisted of 76 items, which were analysed through bibliographic coupling and co-citation analysis. An interpretive approach was taken to articulate the study findings.

The current scholarly debate unfolds through four research streams, which emphasize the need for joint optimizing quality management and organizational culture embracing a longitudinal perspective. Similarly, the theoretical roots inspiring reviewed contributions are distributed in four clusters, which rely on the assumption that organizational excellence derives from the harmonization of quality management and organizational culture.

Quality management necessitates a supportive organizational culture to set the ground for excellence. At the same time, it modifies the inner traits of the organizational culture. Such cultural changes should be carefully handled to ensure a dependable quality orientation. Achieving organizational excellence involves mastering the interplay between quality management and organizational culture.

This article delivers an unprecedented systematization of the scientific literature. It identifies the main research streams through which the debate on quality management and culture evolves, shedding light on the main conceptual roots inspiring recent scholarly advancements. Alongside overcoming the fragmentation of the extant debate, this review enables the envisioning of an agenda for further developments.

This study investigates the effect of total quality management (TQM) on customer satisfaction, personnel satisfaction and company reputation.

The study results rely on a structured survey conducted among an extensive sample of Finnish SMEs. In addition to the examination of the relationship between TQM and company performance in terms of customer satisfaction, personnel satisfaction and company reputation, the study takes a view on the possible effects of the industry, the company size and the certified quality system.

The results reveal that two TQM dimensions, namely Customer Focus and Product Management, were related to companies' customer satisfaction, whereas four TQM dimensions, namely Management/leadership, Customer Focus, Personnel Management and Risk Management, were related to personnel satisfaction. None of the TQM dimensions were related to company reputation. The control variables – the industry, the company size and the certified quality system – were not found to affect customer satisfaction, personnel satisfaction or company reputation.

Most previous studies have been based on traditional TQM classification and have not shown the effects of the latest TQM-related dimensions. Compared to previous studies, this work integrates risk management, digitization, system deployment efficiency and stakeholder management into TQM, which has not been implemented in any previous study. The roles of hard and soft TQM factors have been carefully considered in this study; thus, the study does not place too much emphasis on either direction but provides a balanced picture of the performance of the management systems studied. Although there are studies on the effects of TQM on personnel satisfaction, customer satisfaction and reputation, they are based on a much narrower definition of TQM than that in this study. The business environment is constantly changing, but only a few studies have been conducted to extend the TQM approach. This has led to duplication of studies, and the effects of performance-relevant procedures have not been extensively studied in the past as part of TQM. Therefore, the concept of this study brings significant added value to TQM research and returns the TQM concept to the overall level while considering the requirements of the ISO 9001: 2015 and EFQM 2019 quality standards. The study also considers the effects of ISO 9001 certification and EFQM requirements.

This paper aims to explore how leaders can develop value-based leadership for sustainable quality development in Lean manufacturing.

A qualitative meta-analysis was conducted using data from a three-year study of Lean manufacturing in Sweden using the Shingo business excellence model as an analytical framework.

This study demonstrates that leaders can develop value-based leadership to support Lean manufacturing by defining and articulating the organization’s values and accompanying behaviors that are needed to support the strategic direction; creating forums and time for leaders to identify the why behind decisions and reflect on their experiences to be able to lead a transformative process; and using storytelling to create a coaching culture to connect values and behaviors, to the processes and systems of work.

This paper contributes insights for developing value-based leadership to support a systemic approach to sustainable quality development in lean manufacturing. Findings are based on a limited case sample size of three manufacturing companies in Sweden.

The findings were derived using a unique methodological approach combining storytelling, appreciative inquiry and coaching with traditional data collection methods including surveys and interviews to identify, define and shape value-based leadership in Lean manufacturing.

This paper explores total quality management (TQM) soft domain efficacy in social care organizations to determine the extent to which an organization's project success may stem from soft TQM critical success factors (CSFs).

Non-structured interviews were conducted with 16 managers overseeing the prosthetic device regeneration project of the Italian local health unit (located in Salerno) to explore which soft factors could contribute to the success of a social care multifunctional organization.

Organizations' handling of certain projects, such as pivoting on soft TQM issues, may allow them to be configured as multiservice organizations. Therefore, a conceptual model of a multiservice social care organization is proposed.

From a managerial perspective, this study presents an interesting success case of a multiservice social care organization with a total annual expenditure of €20 million on prosthetic assistance. Preliminary data show a 13% reduction in public expenditure for Salerno's local health unit via a refurbishment project.

The paper contributes to the soft TQM literature debate: although Italian local health professionals appear aware of soft TQM issues' implementation and consciously apply them in their organization and projects, this occurs more with specific CSFs emerging from the literature. Therefore, this article paves the way for further quantitative and theoretical investigations on the adoption of TQM soft issues in social care organizations' performance measurement.

The purpose of this paper is to explore existing and desired methodologies for systematic quality work to promote quality in preschools from the principal’s perspective.

A collaborative approach was used in this research project, and principals were asked to complete portfolio assignments. Their answers to those portfolio assignments were analysed by the research team and subsequently compared to total quality management values.

Existing and desired methodologies for systematic quality work are presented and sorted into 13 and 17 groups, respectively. The principals desire four times more methodologies than they are presently using to promote systematic quality work, and the results show that they must extend their methodologies to support TQM values.

This research is based on answers collected from 18 principals in one municipality in Sweden.

The use of the cornerstone model provides a framework to illustrate the application of TQM in preschools.

Principals struggle to find time for systemic quality work. The presented results can be used to work systematically with quality in preschools and other organizations.

This study examines the theoretical and empirical relationships between LM&SS, human resource management (HRM), climate for LM&SS and outcomes (employee well-being and performance) in hospitals. As part of this research, the authors examine the interplay between “hard” and “soft” practices for LM&SS and “soft” HR practices.

A cross-sectional, multisite survey study covering all internal service units at all eight Dutch university hospitals was conducted (42 units, N = 218 supervisors, N = 1,668 employees), and multivariate multilevel regression analyses were performed.

A systems approach involving “soft” LM&SS practices that are specifically HR-related has a positive effect (β is 0.46) on a climate for LM&SS. A climate for LM&SS is not related to perceived performance or employee health. It is, however, positively related to employee happiness and trusting relationships (both βs are 0.33). We did not find that a climate for LM&SS had a mediating effect.

This study shows that a balanced approach involving both “hard” and “soft” factors is crucial to achieving the desired breadth and depth of LM&SS adoption at the macro, meso, and micro levels. The authors found that a climate for LM&SS positively affects employee well-being in hospitals.

In their attempt to create mutual gains for both their organization and their employees, hospitals that adopt LM&SS should foster a climate for LM&SS by embracing a balanced approach consisting of both “hard” and “soft” practices, thereby internalizing LM&SS at the macro, meso, and micro levels.

This is one of the first studies to examine in-depth the impact of “hard” and “soft” LM&SS on both employee well-being (subdivided into different components) and performance in healthcare, as well as the role of “soft” HRM in this relationship. Linking LM&SS, HRM and outcomes to a climate for LM&SS is relatively a new approach and has led to a deeper understanding of the mechanisms underpinning the internalization of LM&SS in healthcare.

In addressing the housing deficits for the less privileged citizens, the South African government began constructing social housing after coming to power in 1994. However, the construction of these houses is bedevilled with many issues; prominent among them are poor quality of the constructed houses. This study seeks to develop a quality management framework for achieving quality and efficiency in public-sector housing construction, a hallmark of the country's procurement goals.

Telephone interviews were conducted with construction professionals involved in constructing government social houses across South Africa, chosen randomly. The data gathered were analysed using the content analysis method.

The study found that the most significant cause of poor quality government-constructed social housing is multifaceted, categorised into project management-related, procurement-related, contractor-related, corruption-related and political-related.

Failure to develop and implement a quality management framework on government-constructed social housing leads to poor quality social housing.

The study has identified quality-related issues and has developed a Quality Management (QM) framework for the stakeholders involved in the construction of the houses to guide them in the project implementation process to ensure project success and quality standards.

With the growing need for employees to be innovative, public-sector organizations are investing in employee training. This study aims to examine the effects of a combined Lean Six Sigma and innovation training, using action learning, on public-sector employees’ creative role identity and innovative work behavior.

The authors studied a public service agency in Singapore in which a five-day Lean Innovation Training was implemented, using a combination of Lean Six Sigma and Creative Problem-Solving tools, with a simulation on day one and subsequent team-based project coaching, spread over six months. The authors administered pre- and postintervention surveys among all the employees, and initiated group interviews and observations before, during and after the intervention.

Creative role identity and innovative work behavior had significantly improved six months after the intervention, enabled through senior management’s transformational leadership. The training induced managers to role-model innovative work behaviors while cocreating, with their employees, a renewal of their agency’s core processes. The three completed improvement projects contributed to an innovative work culture and reduced service turnaround time.

Starting with a role-playing simulation on the first day, during which leaders and followers swapped roles, the action-learning type training taught all the organizational members to use various Lean Six Sigma and Creative Problem-Solving tools. This nimble Lean Innovation Training, and subsequent team-based project coaching, exemplifies how advancing the staff’s creative role identity can have a positive impact.

This paper focuses on governance in higher education in China. It sees that governance as distinctive on the world scale and the potential source of distinctiveness in other domains of higher education. By taking an historical approach, reviewing relevant literature and drawing on empirical research on governance at one leading research university, the paper discusses system organisation, government–university relations and the role of the Communist Party (CCP), centralisation and devolution, institutional leadership, interior governance, academic freedom and responsibility, and the relevance of collegial norms. It concludes that the party-state and Chinese higher education will need to find a Way in governance that leads into a fuller space for plural knowledges, ideas and approaches. This would advance both indigenous and global knowledge, so helping global society to also find its Way.